Healthcare Provider Details

I. General information

NPI: 1043715626
Provider Name (Legal Business Name): ARTHUR GEORGE AFFLECK IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 W BELVEDERE AVE
BALTIMORE MD
21215-5224
US

IV. Provider business mailing address

2435 W BELVEDERE AVE
BALTIMORE MD
21215-5224
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-0601
  • Fax:
Mailing address:
  • Phone: 410-601-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0104933
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: